Purpose To exp1ore the c1inicopatho1ogica1 features,diagnosis and differentia1 diagnosis of mu1ti1ocu1ar cystic rena1 ce11 carcinoma( MCRCC). Methods 18 cases of MCRCC were reported by microscopy,immunohistochemistry,differentia1 diagnosis and were fo11owed-up. Results A11 patients were adu1ts inc1uding twe1ve ma1es and six fema1es who aged from 26 to 68 years(mean 55. 6 years). Imaging studies revea1ed a po1ycystic mass,with c1ear boundary. Gross1y,the cut surface of the tumors had more cysts of va-rying sizes,containing serous or b1oody f1uid. Microscopica11y,the cyst wa11s of tumors were often covered with a few simp1e c1ear ce11s,stratified epithe1ium or devoid of epithe1ium. The septa contained aggregates of epithe1ia1 ce11s with transparent cytop1asm which showed gradeⅠ nuc1ear features,these characteristics were diagnostic c1ues of MCRCC. Immunohistochemica11y the c1ear ce11 was positive for CD10,vimentin,EMA and Ki-67 showed 1ow pro1iferative activity. 18 case were fo11owed up,mean fo11ow-up 43 months, no case recurred or with metastasis. Conclusion MCRCC is a rare histo1ogica1 subtype of rena1 ce11 carcinoma with more favorab1e prognosis. It shou1d be distinguished from cystic change of c1ear ce11 rena1 carcinoma and cysts of kidney 1esion.

Objective To summarize brain magnetic resonance imaging (MRI) features and differential diagnosis of sporadic Creutzfeldt-Jakob disease. Methods The clinic data of 8 probable Creutzfeldt-Jakob disease cases in our hospital were analyzed retrospectively from January 2009 to June 2014. We mainly analysed the characteristics of brain MR and the causes of misdiagnosis. We had followed up the family members of these patients on the progress and progno?sis of disease. We also analyzed the differential diagnosis of sCJD. Results All the patients presented with rapid progres?sive dementia and mental abnormal behavior as the main clinical manifestations. All the patients had abnormal routine EEG and five of them had a periodical sharp wave complexes. The brain MRI of the 8 patients showed high signal intensi?ties in cerebral cortex (and/or basal ganglia) on diffusion weighted images (DWI) and 5 of them had caudate nucleus and (or) putamen involvement. The lesions were first appeared in DWI imaging as“ribbon-like”high signal, followed by Flair as high signal intensities. lesions were low signal intensities on T1WI and high signal intensities on T2WI. Five pa?tients were misdiagnosed. 2 cases were misdiagnosed as having cerebral infarction,1 case was misdiagnosed as having vi?ral encephalitis, 1 case was misdiagnosed as having Alzheimer's disease, 1 case was misdiagnosed as having vertigo and 1 case was misdiagnosed as having corticobasal degeneration. Conclusions The brain MRI of the sCJD patients showed a certain characteristic. DWI is the most sensitive tool in the detection of lesions which is useful in the early diagnosis of this disease. We should distinguish sCJD form ischemic cerebrovascular disease, encephalitis, and other progressive de?mentia identification.

Objective To establish a new rat model of perinatal brain damage. Methods Wistar rats were randomized into 3 groups: lipopolysaccharide （LPS） plus hypoxia (H) group: 17 d pregnant rats exposure in utero to LPS followed by hypoxia; hypoxia (H)/ ischemia (I) group: postnatal day 7 (P7) pups ligated the right common carotid artery followed by exposure to hypoxia (8% O2 ) for 2 h; control group: P7 pups incised the anteriorl cervical skin only. The footprint analysis, compound muscle action potential (CMAP) and pathological observation were performed after 4 weeks. Results The left limb footprint repeatability of rat in HI and LPS plus H groups was poorer than that in control group （P<0.05）. The hindlimb quadriceps CMAP of rats in HI and LPS plus H groups showed that the wave amplitude was lower than that in control group （P<0.05）. The periventricular cells were irregular, and the periventricular leukomalacia was seen. The morphous of the neurocytes was irregular obviously, part of the nuclear membranes was broken down with the content leakage under transmission electron microscope. Conclusion The animal model for cerebral palsy has established, that mimics more the occurrence of this disease in human.

Objective:To search for evidence related to the prevention and management of mechanical complications in patients receiving enteral nutrition and to summarize the evidence.Methods:The evidence published up to March 20, 2022 was systematically retrieved from Cochrane Library, PubMed, American Clinical Guidelines Network, National Institute for Health and Care Excellence, American Society for Parenteral and Enteral Nutrition, CNKI, WanFang Data, SinoMed, etc. The literature evaluation standards and evidence grading system of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia were used to rate the quality of the literature, evaluate and summarize the evidence.Result:A total of 13 articles were included, including 4 guidelines, 4 expert consensuses, 4 evidence summaries, and 1 case-control study. Totally 31 best evidences were formed from 8 aspects: causes of occurrence, prevention and management, proper immobilization, regular flushing, reasonable infusion of nutrient solution/medication, treatment of complications-blockage, treatment of complications-mucosal damage, and treatment of complications-unplanned extubation.Conclusions:Medical and nursing staff can use the best evidence to develop and implement prevention and management programs for mechanical complications in patients receiving enteral nutrition, strengthen the scientific management of mechanical complications in these patients, and improve the quality of life and prognosis of patients.

OBJECTIVE To investigate the present equipment and management situation of narcotic drugs in primary healthcare institutions from Qiandongnan prefecture of Guizhou province. METHODS The questionnaire survey was conducted among pharmacy department heads and medical staff from primary healthcare institutions in Qiandongnan prefecture of Guizhou province. Descriptive statistical analysis was conducted on the survey results. RESULTS Of 251 healthcare institutions in this survey， 29 healthcare institutions were equipped with narcotic drugs， accounting for 11.55%. The reasons for the narcotic drugs unequipped were mainly as follows: insufficient attention， no storage conditions for narcotic drugs， complex program of narcotic drug management， small amount usage and so on. Among the 29 primary healthcare institutions equipped with narcotic drugs， all of them did not monitor patient usage， accounting for 100%； 29 healthcare institutions did not implement a return visit or follow-up every 3 months， accounting for 100%. CONCLUSIONS The health administration departments should strengthen the administration of narcotic drugs in primary healthcare institutions. At the same time， training on standardized management and clinical rational application of narcotic drugs for medical staff in primary healthcare institutions should be enhanced by the health administrative department.